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Session: ePoster: IBD 6 (Sat315)

EP136 - Post-operative Complications in Patients with Inflammatory Bowel Disease with Infections on Admission

Saturday, May 10, 2025
3:42 PM – 3:47 PM PT
Location: Monitor 5, Sails Pavilion, Upper Level

    ePoster Presenter(s)

  • John J Newland, MD, MS

    Resident Physician
    University of Maryland
    University of Maryland
    Baltimore, MD, United States

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

    • Author(s)

  • RB

    Rachael Belcher, MD

    Resident Physician
    University of Maryland
    Baltimore, Maryland, United States

    Disclosure information not submitted.

  • JG

    Joel Grunhut, MD

    Resident Physician
    University of Maryland
    Baltimore, Maryland, United States

    Disclosure information not submitted.

  • RB

    Rebecca F. Brown, MD

    Associate Professor
    University of Maryland School of Medicine
    Baltimore, Maryland, United States

    Disclosure information not submitted.

  • KL

    Kerri Lopez, MD

    Assistant Professor
    University of Maryland School of Medicine
    Baltimore, Maryland, United States

    Disclosure information not submitted.

  • SE

    Samuel Eisenstein, MD

    Associate Professor
    UC San Diego Health
    La Jolla, California, United States

    All of the relevant financial relationships listed below have been mitigated.
    Takeda: Consultant (Ongoing)

    • Senior Author(s)

  • AB

    Andrea C. Bafford, MD

    Associate Professor of Clinical Surgery PAR
    Johns Hopkins University School of Medicine
    Baltimore, Maryland, United States

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

All of the relevant financial relationships listed below have been mitigated.
John J Newland, MD, MS: This individual has no financial relationships with ineligible companies.
Samuel Eisenstein, MD: Takeda: Consultant (Ongoing)
Andrea C. Bafford, MD: This individual has no financial relationships with ineligible companies.
Image or Table (Do Not add text here):

Purpose/Background: Patients with inflammatory bowel disease (IBD) are frequently immunocompromised due to their disease state and/or medication exposure. For patients with infections present on admission (IPOA), the rate of post-operative complications has not been established. The purpose of this study was to evaluate postoperative complications in patients with IBD who present with IPOA.

Methods/Interventions: This is a retrospective cohort study using data from the IBD-NSQIP data collaborative – a national database comprised of patients with IBD undergoing surgery. The primary exposure was IPOA in patients with IBD undergoing surgery. The primary outcomes included post-operative wound complications (WC) and adverse events (AE). Univariate and bivariate analyses as well as a multivariable logistic regression were performed to determine covariates associated with postoperative complications.

Results/Outcomes: 5682 patients were included in the study using IBD-NSQIP data between 2017-2023. Of the included patients, 108 had IPOA. 54% of patients in the IPOA group had Crohn’s disease (CD), 21% had ulcerative colitis (UC), and 25% had indeterminate colitis (IC) compared to those who presented without IPOA, of whom 54% had CD, 36% had UC, and 9% had IC (p < 0.05). Rates of AE were 70% for those with IPOA and 16% for those without (p < 0.05). WC rates were 68% for those with IPOA and 9.8% for those without (p < 0.05). 12% of patients with IPOA and 37% of those without had taken preoperative steroids within 60 days of surgery (p < 0.05). 38% of IPOA patients used a biologic agent within 60 days prior to admission compared to 22% of patients without IPOA (p < 0.05). There were no differences between the IPOA and non-IPOA groups in age, race, ethnicity, BMI, gender, and rate of emergency surgery. The stepwise multivariable logistic regression revealed increased odds of AE (OR 11.2 [7.1-17.7], p< 0.05) and WC (OR 17.2 [11.0-26.8], p< 0.05) in patients with IPOA. For the whole cohort, the use of biologic agents was associated with an overall decreased odds of AE (OR 0.78 [0.6-0.9], p< 0.05), but similar odds of WC. Minimally invasive surgery (MIS) was associated with decreased odds of both AE (0.58 [0.5-0.7], p< 0.05) and WC (0.59 [0.5-0.7], p< 0.05).

Conclusion/Discussion: In patients undergoing surgery for IBD, those who present with infections have significantly increased odds of both AE and WC compared to those without. The use of biologic agents in patients with IPOA was higher than those without IPOA, however for the whole cohort, biologic agents were protective against AE but not WC. MIS was protective against both AE and WC. Typical predictors of poor surgical outcomes continue to be associated with an increased odds of AE and WC. Preoperative optimization including adequate treatment of IPOA, as well as minimizing comorbid conditions, the use of biologic agents, and minimally invasive surgical techniques are associated with decreased odds of postoperative complications in patients with IBD undergoing surgery.